Pain, Range of Motion, and Psychological Symptoms in a Population with Frozen Shoulder: A Randomized Controlled Dismantling Study of Clinical EFT (Emotional Freedom Techniques)

Clinical EFT (Emotional Freedom Techniques) combines acupoint stimulation with elements of cognitive and exposure therapy. Numerous studies have demonstrated the efficacy of EFT for depression, anxiety, phobias, PTSD, and other psychological conditions. The current study assesses whether acupoint stimulation is an active ingredient or whether treatment effects are due to non-specific factors. Thirty-seven participants with "frozen shoulder" consisting of limited range of motion (ROM) and pain were randomized into a wait list, or one of two treatment groups. ROM, pain, and the breadth and depth of psychological conditions such as anxiety and depression were assessed before and after a 30-minute treatment session, and 30 days later. One treatment group received Clinical EFT, while the other received an identical cognitive/exposure protocol but with diaphragmatic breathing (DB) substituted for acupoint stimulation. No significant improvement in any psychological symptom was found in the wait list. Participants in the both the EFT and DB groups demonstrated significant posttest improvement in psychological symptoms and pain. Follow-up showed that both groups maintained their gains for pain, with EFT superior to DB, but only the EFT group maintained gains for psychological symptoms (p less than 0.001). Large EFT treatment effects were found, with a Cohen's d = .9 for anxiety and pain, and d = 1.1 for depression. Though EFT showed a greater trend for improved ROM in most dimensions of movement, changes were non-significant for most measures in all groups. Reductions in psychological distress were associated with reduced pain as well as with improved ROM. The results are consistent with five earlier dismantling studies showing that acupoint stimulation is an active ingredient in EFT treatment. The study adds further support to other clinical trials indicating that Clinical EFT is an efficacious evidence-based treatment for pain and psychological conditions.

临床情绪释放疗法（Clinical EFT，Emotional Freedom Techniques）将穴位刺激与认知疗法及暴露疗法的元素相结合。已有多项研究证实EFT在抑郁症、焦虑症、恐惧症、创伤后应激障碍（PTSD）及其他心理疾病中的治疗效果。本研究旨在探究穴位刺激是否为EFT的有效活性成分，抑或是治疗效果源于非特异性因素。本研究共纳入37名冻结肩患者，其症状表现为活动受限（Range of Motion，ROM）与疼痛，将其随机分配至等待组或两个治疗组之一。研究人员在30分钟治疗疗程前后以及治疗后30天，分别对受试者的活动度、疼痛程度以及焦虑、抑郁等心理症状的严重程度与波及范围进行评估。其中一个治疗组接受临床情绪释放疗法，另一组则采用完全一致的认知/暴露疗法方案，但以腹式呼吸（DB）替代穴位刺激。等待组未出现任何心理症状的显著改善。EFT组与DB组受试者在治疗后均表现出心理症状与疼痛程度的显著改善。随访结果显示，两组受试者的疼痛改善效果均得以维持，且EFT组优于DB组；但仅EFT组的心理症状改善效果得以保持（p<0.001）。本研究发现EFT具有显著的治疗效应：针对焦虑与疼痛的科恩d值（Cohen's d）为0.9，针对抑郁的d值为1.1。尽管EFT在多数运动维度上呈现出改善活动度的趋势，但所有组别的多数测量指标变化均无统计学显著性。心理痛苦程度的减轻与疼痛缓解及活动度改善均存在相关性。本研究结果与此前五项拆解式研究的结论一致，均证实穴位刺激是EFT治疗中的活性成分。本研究进一步为其他临床试验提供了支持证据，证实临床情绪释放疗法是一种针对疼痛与心理疾病的有效循证治疗手段。